Multicenter comparison of PEG-IFN α2a or α2b plus ribavirin for treatment-naïve HCV patient in Korean population

Abstract

BackgroundTwo recent Italian studies suggested that Pegylated-interferon (PEG-IFN) alfa-2a achieves a higher sustained virological response (SVR) rate than PEG-IFN alfa-2b. We intended to compare the efficacy and safety of PEG-IFN alfa-2a with those of PEG-IFN alfa-2b in Korean patients with chronic hepatitis C virus (HCV).MethodsThis retrospective, multi-center trial was conducted on 661 treatment-naïve chronic HCV patients. Patients received PEG-IFN alfa-2a (180 μg/week; n=402) or PEG-IFN alfa-2b (1.5 μg/kg/week; n=259) with ribavirin (800–1200 mg/day) for 24 or 48 weeks according to HCV genotypes.ResultsEarly virologic response and sustained virologic response (SVR) rates were not significantly different between two PEG-IFN groups both in patients with HCV genotype 1 (all P-values>0.05) and 2/3 (all P-values>0.05). SVR rates were not different between two groups in each categorized baseline characteristics: age (years) (≤50 and >50), HCV viral load (IU/mL) (≤7×105 and >7×105), and hepatic fibrosis (F0-2 and F3-4) (all P-values >0.05). In additional analysis for 480 patients who sufficiently complied with treatment doses and duration (80/80/80 rule) and propensity-score matched analysis, SVR rates were not different between two groups both in patients with HCV genotype 1 and 2/3 (all P-values >0.05). Adverse event rates were similar between two groups.ConclusionsUnlike the Western data, efficacy and safety of PEG-IFN alfa-2a were similar to those of PEG-IFN alfa-2b in chronically HCV-infected Korean patients regardless of age, HCV viral load, and hepatic fibrosis.

Treatment Response and Long-Term Outcome of Peginterferon α and Ribavirin Therapy in Korean Patients with Chronic Hepatitis C

“…These results were better than those reported in Western studies (13% to 33% for genotype 1/4 and 31% to 57% for genotype 2/3)8,17–19 and in small Korean studies (21% to 24% for genotype 1 and 33% to 53% in non-1 genotypes) 20,21. In addition, SVR rates in the current study reached 67% among patients without cirrhosis with HCV genotype 1 and 86% in those with non-1 genotypes, also better results compared to large-scale Western studies (57% to 60% for genotype 1 and 76% for non-1 genotype groups),8,22 but similar to other Korean data (74% for HCV genotype 1 and 83% in genotype non-1) 11…”

“…Although some Korean studies have reported relatively higher SVR rates in patients with HCV genotype 1 and non-1 genotypes compared to Western studies,11,12 the reasons for these improved responses have not been clearly delineated, and the response rate in cirrhotic patients remains uncertain. Some Western studies demonstrated that successful antiviral treatment in patients with CHC halted progression of hepatic fibrosis, but the risk of hepatocellular carcinoma remained even after achieving SVR 8,13.…”

Evaluation of Dual Therapy in Real Life Setting in Treatment-Naïve Turkish Patients with HCV Infection: A Multicenter, Retrospective Study

“…Asconi, Rumi and Awad found that peginterferon alpha-2a was superior to peginterferon alpha-2b (35)(36)(37). However, in other studies carried out by McHutchison et al (38) and Jin et al (39), no difference was found between peginterferon alpha-2a and 2b in terms of SVR. In two studies conducted in GT 1 patients in Turkey, no difference was found between two peginterferons.…”

Current issues in comparative effectiveness research for hepatitis C

“…After a manual review, 118 duplicates and 650 studies irrelevant to our objectives were excluded, and 134 studies remained for further screening. Applying the inclusion and exclusion criteria, a total of 19 studies (four randomized control trials [RCTs], [14][15][16][17] ten meta-analysis studies, [18][19][20][21][22][23][24][25][26][27] three nonrandomized intervention studies, [28][29][30] one cross-sectional study, 31 and one cohort study 32 ) were included for the updated studies for this review (Table 1). Additionally, eight RCTs were also included in this review that were published during the study period of Chou et al 13 and met the inclusion/exclusion criteria, but were not reviewed by them.…”

“…Another retrospective multicenter trial conducted in Korea discovered that PEG-IFN alfa-2a and PEG-IFN alfa-2b had similar effects on SVR and adverse events rate, even after controlling for age, HCV viral load, and hepatic fibrosis. 29 A meta-analysis study, Flori et al, 18 investigated eleven randomized and 15 nonrandomized trials to evaluate the effectiveness of PEG-IFN alfa-2a vs PEG-IFN alfa-2b. 18 This study suggested that PEG-IFN alfa-2a plus RBV was more effective than PEG-IFN alfa-2b plus RBV, especially in genotype 1 or 4 HCV patients.…”